If you’re working in the field of Social Prescribing and seeing clients, you may have had days or even weeks where some or many people don’t show up. One piece of research has suggested that deprivation is the biggest driver of missed GP appointments (Lancet, Dec ’17) so it makes sense that Social Prescribing clients can sometimes be difficult to engage.

Here are 5 ideas that have helped me boost client attendance so that more people can benefit from our service

1) The telephone; it’s how you use it! It’s likely your first contact with the client will be on the phone. Here are some tips that have helped me to engage with my clients successfully. Getting hold of a client: Some people don’t answer unknown numbers, so you can text ahead to introduce yourself then call shortly after, or leave a voicemail or text asking them to get back to you (texting seems to trump voicemail nowadays!). OK, maybe this sounds too obvious, but it can be a tricky business! Ask: “Do you think a face to face appointment would be useful for you?” Ask this rather than going straight ahead and booking them in for an appointment they may not really be committed to attending. Telephone signposting: If your client’s needs are clear then simply assist them over the phone with the information they need to save time for both of you. Telephone appointments: These are great if your client has certain barriers (see point 2). Timing is everything: Use the information you have about the client to judge when might be the best time to first call. Maybe they are busy because of school runs or work or they are retired or unemployed. For me, overall I find more people answer late morning!

2) Discuss your client’s barriers. Our clients can feel that lots of things are holding them back, which is partly why they are seeking support (or the GP has recommended it). These barriers may stop them at the first hurdle from even attending a social prescribing appointment. Try to find a time, place and type of appointment that best suits your client (as far as you have the resources). Are they a morning person? They can have the 9am slot! Are they afraid of busy waiting rooms? Find out the least busy time for the practice (if practice based). Do they have a school run to do? Do they work 9–5pm or nights? Are they afraid of leaving the house? Do they have a bus to catch which is better at a certain time of day? Does that cost them money? Are they a carer? All of these factors might mean that someone misses an appointment or disengages completely, so be frank and try to get a sense of these within your first appointment with your client

3) Text an appointment reminder the day before. Sounds simple and many of you probably already do this, because often people forget or haven’t written down their appointments, but I’ve found that wording the message to promote accountability can actually make a difference! For example, I used to write something like ‘Hi ……just a quick reminder of your appointment tomorrow at 2pm at …..Surgery, Best wishes, Will’ and now I write ‘Hi….appointment confirmed for tomorrow at 2pm at ….Surgery. See you tomorrow. Will’. Perhaps the first one is too casual but since using the second one, fewer clients have texted me back to say ‘Sorry I can’t make it’ and more have attended, I think because it sounds more formal. So if you’re getting lots of no shows, try playing with your wording!

4) Sense your client’s commitment. After the first appointment, I always try to ask the client two questions. “Was that helpful today?” and “Would it be useful for you to have another appointment?” Of course, I also say what I think might be useful for them but it’s a joint decision. If you sense the client is being polite or hesitant and just re-booking because they think they should, then try to be open and say that it really is only if they think it would help them. After the first appointment they may still not be quite ready to get support or set goals, or it may not be for them.

5) Book short and long slots. I used to book 45 minute slots for all of my clients, but then if one doesn’t arrive that’s a lot of time wasted. Now I book 20 minute slots and 45 minute slots. The shorter slots work well for follow ups and more regular clients and the longer ones for new clients. I also ask the client which length of appointment they would prefer. This means I can book more clients in per day and if any don’t show up then it’s not as much of a problem.

Of course, managing our client case-loads is a bit of an art and it depends on the types of clients you’d like to engage. Here in Bristol, we are working in the areas of deprivation as part of a citywide Public Health backed project. I hope that in sharing my experiences you’ve picked up something useful and would love to hear your thoughts, ideas and best practice

We were delighted to exhibit at the King’s Fund social prescribing conference on 6th November 2018.

It was a colourful event indeed and it was fantastic seeing familiar and new faces. Over 100 people caught our link worker effect and signed up for further conversation at our stand 🙂 We are very grateful for the lovely feedback from visitors to our stand. Here is a taster

‘it was a great event and I very much enjoyed visiting the Connect Link stand’

The secretary of state for health and social care, Matt Hancock also caught the link worker effect when he met with our CEO. Great support for link workers! In his keynote speech, he reiterated his commitment to social prescribing and that he was open to ideas with proven evidence and wasn’t wielded to a model. You can read his full speech.

2 key issues that emerged

2 key issues that emerged from the over 100 conversations we had with visitors to our stand:

1) Lack of a repository of all social prescribing schemes: visitors were asking for information regarding existing social prescribing schemes in their area. Social prescribing coming of age should mean improved coordination and dissemination of information. There now needs to be a collation of existing social prescribing schemes for easy public access.

2) Lack of social prescribing link worker role clarity

Firstly, it is important to clarify that we are referring to a non-clinical social prescribing link worker. It is worth noting that our members involved in social prescribing schemes are non-clinical and we are very clear about their role. Again, this highlights a lack of a coordinated dissemination of information.

The awaited NHS England social prescribing guide should help provide role clarity. Here is an excerpt.

Next steps
Get in touch with us info@connectlink.org, if you have questions or for either of the following:

• Want to discuss membership?
• Want to support our link worker success conference 2019?
• Do you have an idea you would like to discuss with us?
• Do you have a project in the pipeline and would like to work with us?
• Would you like to get involved with our work?
• Do you want to be listed in our social prescribing marketplace?
• Want to discuss bespoke training?
• Do you want to discuss embedding social prescribing?

How it started:
Our Social Prescribing and Wellbeing Project was set up at the GP surgery as a pilot project, about 18months ago, in response to an identified need. This need came about because a relatively new service, at the time, provided by a Community Navigator was becoming inundated and overloaded with requests from GPs across the city to signpost patients, who presented with non-medical issues, to services for support with a range of social or emotional (i.e. non-medical) needs.
The presentation to the Patient Participation Group (PPG) resulted in an interested group of volunteers being trained by the local CVS/Community Navigator team and then some of those volunteers taking the project forward with the surgery’s support.

Our impact:
• As volunteer link workers, we support the (18000 +patients) surgery by spending more time with patients who have non-medical issues but don’t know where else to go. Patients appreciate the time we give them
• For complex cases we can escalate to the Community Navigator
Support we received
• We received initial training which focused more on active listening and protective behaviours a couple of us spent time at the local CAB.
• The surgery is very appreciative of what we are trying to do and we have a proactive GP and Practice Manager who are keen that we should succeed.
• We have been invited to surgery meetings to give feedback and they would like us to have our photos on the board alongside other staff members to show the patients who we are.

How we work:
• Clinics are held on 2 half days per week so that a consulting room is always available
• We have devised a closed group scheduling system on Yammer
• We have produced a small referral pad which each of the GPs, Nurses and Receptionists can use to give to a patient to take to reception to book an appointment. This also acts as a reminder to the GPs of the service available by the volunteers.
• By developing strong links with the surgery, we have a secure email account that allows us to share referral forms back to the surgery to update patients records
• We have refined our IT trails so that we have as much face to face time with the patient as possible
• We are proactive in gathering leaflets, learning on the hoof, drawing on our backgrounds and general knowledge.

The issues have been:
• Recruiting and keeping volunteers
• Finding a system for scheduling the rota
• Designing a system/paper & electronic trail that works for all parties
• Having a manageable IT system for recording actions and follow ups
• Having a dedicated space within the surgery to see patients
• Getting sufficient referrals from the GPs
• Lack of funding
• Training for volunteers/ new recruits
• Knowing what 3rd party services are currently available
• Getting volunteers’ faces known around the surgery

Written by our member Angela Bettridge (volunteer link worker) The Maltings Surgery, St Albans in Hertfordshire.

Join us if you are interested in ending link worker professional isolation and would like a single point of access for empowering and supporting the social prescribing workforce inorder to help increase positive wellbeing outcomes for themselves, individuals and communities.

Goal 1. End poverty in all its forms everywhereGoal 2. End hunger achieve food security and improved nutrition and promote sustainable agricultureGoal 3. Ensure healthy lives and promote well-being for all at all agesGoal 4. Ensure inclusive and equitable quality education and promote lifelong learning opportunities for allGoal 5. Achieve gender equality and empower all women and girlsGoal 6. Ensure availability and sustainable management of water and sanitation for allGoal 7. Ensure access to affordable, reliable, sustainable and modern energy for allGoal 8. Promote sustained, inclusive and sustainable economic growth, full and productive employment and decent work for allGoal 9. Build resilient infrastructure, promote inclusive and sustainable industrialization and foster innovationGoal 10. Reduce inequality within and among countriesGoal 11. Make cities and human settlements inclusive, safe, resilient and sustainableGoal 12. Ensure sustainable consumption and production patternsGoal 13. Take urgent action to combat climate change and its impacts*Goal 14. Conserve and sustainably use the oceans, seas and marine resources for sustainable developmentGoal 15. Protect, restore and promote sustainable use of terrestrial ecosystems, sustainably manage forests, combat desertification, and halt and reverse land degradation and halt biodiversity lossGoal 16. Promote peaceful and inclusive societies for sustainable development, provide access to justice for all and build effective, accountable and inclusive institutions at all levelsGoal 17. Strengthen the means of implementation and revitalize the global partnership for sustainable development

World social prescribing

As a result, organisations and governments globally are increasingly putting the SDGs at the heart of their impact framework and approaches.

Social prescribing impacts upon all 17 goals . As such, governments and organisations that are not yet aware of the benefits of social prescribing should be made aware and be supported to include social prescribing as part of their SDG implementation strategy. What are your thoughts?

If YOU are an individual or organisation who is interested or involved in social prescribing and would like to improve positive wellbeing outcomes JOIN US

We welcome local, national and international collaboration. Get intouch admin@connectlink.org

Since 20% of our health is accountable to healthcare; we need to provide social prescribing as the solution to the 80% that are largely non-medical. This is basically a no brainer, isn’t it! We need to stop over medicating people unnecessarily but rather support them live longer in good health by addressing the non-medical wellbeing issues affecting their health. What do you think!

The NHS Health and Innovation Expo 2018 was held in Manchester on 5th and 6th September.

We were excited that this year’s Expo had a focus on prevention and social prescribing because we know that our health and care needs today are different from those the NHS was designed 70years ago.

As a result, adapting to patients needs means focusing on a personalised care approach and preventing the root causes of ill-health rather than waiting to treat it’s consequences. The good news is that social prescribing is one of the major responses to this.

We look forward to social prescribing and prevention featuring in the long term plan for the NHS. Help develop the plan

These 4 NHS England Social Prescribing (SP) priorities were revealed at the event

Support the commissioning of local SP community connector schemes as part of a personalised care approach

Support mental health trusts to connect people to community groups

This depends on partnership working, sustainable local voluntary organisations and community groups

I am very grateful I sign up, a well-constructed course for the target audience of GP Practice and voluntary and charitable staff involved with social prescribing or community navigation to develop new knowledge and skills to improve wellbeing- Link worker

Being alienated from your social group is something that happens very often when you are suffering from any kind of debilitating disease. This is something that can make people feel extremely depressed and unhappy. They feel like there is no one out there who can relate, and they even feel uncomfortable and angry when they see everyone else in their lives enjoying their health. These feelings can’t be helped, and they unfortunately create large gaps between people.

The good news is that social connectivity via online and offline has come to change that forever. Now people can find others who are suffering from their same problem or share similar interests. Forums, self help groups are extremely popular outside of social media networks and there are also pages and groups that are dedicated to all kinds of health issues. The point is that people can easily find a place where they can feel accepted and supported.

Having a community that you can see as the place to feel welcome and supported is extremely powerful. Online communities have become a huge part of this process with many groups that are dedicated to support for people who suffer from all kinds of physical and mental health issues.

Social prescribing can help encourage people to start making significant changes in their lives by facilitating social connections and signposting to appropriate support groups. These groups have given a large number of people the chance to find support and to stay motivated as they are dealing with their condition or issues.

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About us

We are the No.1 professional membership network for link workers. A self help initiative by those involved in link worker roles. A social enterprise for ending link worker professional loneliness and isolation. Our membership provides a single point of access for raising the profile of link workers, empowering and supporting them.
Our cause is to provide a single point of access for the link working workforce empowerment, development, networking and support in order to help increase positive wellbeing outcomes for themselves, individuals and communities. Today, over 500 link workers are making the most of our services and increasing positive wellbeing outcomes for themselves, individuals and communities.